Level 1: Available for single care recipients who do not have memory issues. Assistance with housechores, cooking, companionship , shopping, driving/errands , walking safely, bathing, grooming, dressing, and medications​​.

Level 2: Available for single care recipients or couples where only one needs assistance. Includes all of Level 1 and Memory care for "mainly agreeable" dementia patients, toileting, ​and 1 person transfers.

Level 3: Available for single care recipients or couples where both need assistance. Includes all of Level 2 and Hospice / bedridden "total care", memory care for all levels of dementia.

Using the above descriptions, which Care Level is best for your situation?
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Level 1 Level 2 Level 3 (non hospice) Level 3 (hospice) Not sure

Are you aware of our hospice patient program?

Yes and I am interested in it. Yes and I am not interested in it. No and I would like to learn about it.

Need service for :
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5 days per week 6 days per week 7 nights/6.5 days( 1/2 day off a week)

First Name(s) and age(s) of the care recipient(s)

We have (or will have) a furnished spare bedroom for the live-in.
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Yes No (Sorry, you do not qualify for our service)

Driving requirements

No driver's license is required Driver's license is required Driver's license and a car is required Not sure

Does anyone smoke tobacco in the home?
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No Yes Unsure

Are there any pets in the home?
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Brief description of your situation or any comments.

Tell us any special needs or details about your situation.

How did you hear about Grandma Joan's Service?
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Are you interested in using a Geriatric Care Manager local to the care recipient to help assess and monitor the situation?

YES NO Not Sure Tell me more

1. Print a copy for your records (optional)

2. Submit the form

We will call you within 1 business day to discuss your inquiry, and confirm your rate. If you dont want to wait..call us Mon-Sat 9am-8pm EST at 888.250.2631 Option 2.